Anxiety and Avoidance Explained (Podcast Episode 350)

Avoidance and anxiety. If you are struggling with anxiety or an anxiety disorder, you are often told that avoidance makes things worse. But there's a lot of confusion about avoidance in our community. What is avoidance? What isn't avoidance? What exactly are you avoiding that you shouldn't be avoiding? If you give me about 15 or 20 minutes today, I will explain it. So, let's get to it. So, today I want to talk about the topic of avoidance and anxiety and anxiety disorders. Avoidance is a thing that creates an anxiety disorder or a chronic state of anxiety and then perpetuates the problem and it's very counterintuitive. Because it would seem like you're supposed to avoid things that make you uncomfortable. But when we talk about avoidance in the context of anxiety, OCD, anxiety disorders, people often get confused. They will say, "Well, if I am ignoring my thoughts or my sensations." And by the way, ignore is not the right word. We've talked about that in other podcast episodes. But if I try to ignore my scary thoughts or my scary symptoms, isn't that avoidance?" And the answer is, "No, that is not avoidance at all." And we're going to get into that. But before we do, just a quick reminder that the anxious truth is more than just this video, this podcast episodes. There are way more episode uh there are way more uh resources on my website at the anxious truth.com. So, if you'd like to know more about this sort of stuff, go over there and check it out. I do a podcast called Disordered with my buddy Josh Fletcher that comes out every Friday. We are hanging out in the Disordered Community Space if you want to interact with me or Josh or others that are sharing your experience. There are very very low-cost workshops that I've put out on this topic. There's free email resources. There's 349 free podcast episodes and videos before this and all my social media stuff. So, if what you find here today is helpful and you want to learn more that you might be able to use in your anxiety recovery journey, if you will. Oh my god, I just said the word journey. Go check out my website at the anxious truth.com and avail yourself of everything that's there, free or otherwise. Anyway, let's talk about avoidance. People will often ask, "But if I try to ignore my scary thoughts, my intrusive thoughts, my anxiety sensations, my symptoms, the things that bother me, isn't that just avoidance? And especially if you are a generalized anxiety disorder sufferer and you are an overthinker or an overworrier, people will often say, "Yeah, but if I try to not solve all of those worries, aren't I just ignoring the problem?" And the answer is no. One of the things that is critically important in our context is that we recognize the difference between content and process. I've talked about this on this podcast. Josh and I talk about it in Disordered. I've written about it. When we look at the actual content of your intrusive thoughts or your scary thoughts or your worries, maybe you have intrusive thoughts about sexual identity or self-harm or harming others or maybe you have health anxiety and your thoughts are always about your health or maybe your anxiety presents a little bit more somatically and you are scared of the physical sensations that come along with anxiety and fear. Whatever it happens to be, it doesn't really matter. If you're a GAD person and you find yourself constantly worrying and overplanning and overthinking about specific real things in life, you might be tempted to say, "If I learn to not engage with those triggers, my symptoms, my thoughts, my emotions, whatever makes you uncomfortable, I'm ignoring the problem I'm ignoring the problem. That's avoidance and that's the problem, right?" No. That's the content of your anxiety. Is the is the subject itself. It is the symptoms, it's the places that trigger the symptoms, it's the content of the thoughts, it's the themes of your OCD, it's whatever particular disease your health anxiety is latched onto right now. It's whatever worry your GAD has decided is most important today. The process that we care about and this tells us where avoidance is, is that those thoughts, those scary intrusive thoughts or intrusive images, those seemingly real-life worries, those physical sensations that seem unhandleable, those really powerful emotions, mainly fear, that make you feel like you're going to snap at any moment, those just create a feeling of fear or discomfort. The problem is that the process is that these internal experiences create a more important internal experience that we will call distress or discomfort. It will be fear, anxiety, uncertainty, feelings of vulnerability, not knowing, feeling like you're about to lose it. It's uncomfortable. You are trying to avoid the discomfort. So, it doesn't really matter what the trigger for that discomfort is. Now, I understand that that might sound ridiculous. If you have OCD or let's say you have relationship OCD and your OCD has latched on to, you know, the strength of your intimate relationships or your romantic or family relationships, you're going to say, "What do you mean it doesn't matter? Of course it matters." If you have a health anxiety, you're going to say, "What do you mean health doesn't matter? The my health or the health of my loved ones is critically important. Of course it matters." If you are struggling with somatic symptoms like air hunger or you know, rapid heartbeat or maybe you're feeling depersonalized, you're going to say, "Of course that matters cuz it feels like I'm dying or something is wrong with me and I need immediate help." But, that's not really the point. The point is that these things make you very uncomfortable. You are not trying to solve a symptom, even though you might want to solve a symptom, you're not really trying to solve an intrusive thought or a worry that you cannot seem to resolve no matter how much you worry about it. You are only trying to get away from the discomfort that that causes inside of you. That is the defining characteristic of anxiety disorders and adjacent uh conditions like OCD. When a person who has a non-disordered form of anxiety is triggered because maybe they're having money problems or real or real relationship problems or actual health challenges or life was just really difficult, which can happen to anybody, they understand that they are feeling fear or discomfort or stress or anxiety because something is going on in their life that they have to deal with outside of themselves. They feel because you feel, therefore, which is one of those critical things that we have to pay attention to when we're in the particular context that I'm addressing. And when do you say I have a scary thought or I am worried about a thing that seems so important, but I can't get a handle on it, or my body keeps doing these things that scare the hell out of me, and you hear people like me teaching you to respond to that in a non-engagement kind of way, which is not ignoring, by the way. I've talked about this extensively and will continue to do so, but I have to just learn to let my heart race without fixing it. I have to just learn to feel air hunger without fixing it. I have to learn to have scary thoughts about harm or self-harm without fixing them. I have to learn to have scary thoughts about my relationship or loving my kids or losing my memory or losing my sanity or I have to just be worried about my health or worried about everything because I'm supposed to worry because I'm a parent and that may means I love my kids or whatever your presentation happens to be, you are going to say, "Well, if I if I don't engage with those scary thoughts or those symptoms or those sensations or those worries in life, then I'm ignoring the problem and that's the avoidance, right?" No, that is actually not correct. The avoidance is I'm trying to not feel so uncomfortable. So, when you engage in safety, escape, and avoidance behaviors, if you have somatic sensations that scare you and you constantly have to get ice packs to, you know, cool you down because hot feels dangerous. If you're constantly trying to calm your body down because you think your heart is your enemy now. If you're constantly sighing and trying to fill your lungs completely up all day long because air hunger feels like suffocation. If you're constantly looping through thoughts about death or existence or relationships or harm or self-harm or sexual identity or health or anything that seems to be stressful in your life and you think you're supposed to stay ahead of with worry and planning and thinking and you can't seem to consistently solve those particular problems, really the triggers, you are only engaging in avoidance and escape and retreat and looping through and overthinking and arguing with your thoughts and trying to tamp down emotions, you are trying to avoid the discomfort. So, non-engagement responses, I have a scary thought about something, whatever OCD theme or anxiety fear is is present for you now, I have a scary thought, I recognize that it makes me scared because it's a scary thought, I recognize I didn't ask for that but it's here, I can't seem to control it, it makes me very uncomfortable or somatically, I notice that my body is doing that thing again where it seems to be in fight or flight mode even though there's no reason and that scares the heck out of me. I want to keep going to the emergency room or the A&E if for my British friends, I want to keep calling for help, I want to call a safe person, I want to ask for reassurance, I want to ask ChatGPT, I want to go to my anxiety support group and see if anybody else ever has this experience so I know it's safe. That is the part that you are trying to not do. You have to just let your discomfort be there and roll through it. Now, I know easier said than done, we talk about this all the time, it is simple but hard to do. The action you take in response to the discomfort is the avoidance. So, believe it or not and let me break this down, especially for people who are overthinkers, over worriers, over planners, that's the GAD presentation, or people with OCD who tend to deal with intrusive thoughts that keep cycling through again and again and again, the way you mentally respond to those things by engaging in repetitive looping thinking and arguing or reassurance seeking or trying to prove that the thought isn't true or replace the thought with something else, that's the avoidance. So, if you just, you know, if your brain is in a situation right now where it's going to make a thought, well, what if you kill the dog? I know that sounds terrible but that's a thing that people with OCD might have a thought about and they don't want to do that, by the way. That's why it's called intrusive, and it triggers you and gets you really uncomfortable. You can just let that go, and just let that discomfort be there. You are not avoiding the problem of hurting the dog, because hurting the dog, or whatever it is scary thought that you are stuck on, is not the problem. It's everything you do to try to prove to yourself that you're not going to hurt the dog, or not act on that scary experience or thought. It's all the things you do to make sure that your body isn't actually self-destructing, that you're not dying, that you don't need medical emergency medical assistance immediately in an urgent kind of way. That is the avoidance. You are trying to get away from the fear, the anxiety, the discomfort. So, it is perfectly okay. In fact, it is preferable, and people like me who treat these things professionally, who specialize in anxiety disorders, people like me who have gone through it, who have lived it, and come out the other side, had to learn non-engagement responses. Now, sometimes we actually do exposures that trigger those things intentionally, and then we work on not doing the saving thing, or the avoidance thing. We leave the thought alone. We leave the sensation alone. We let it come and go. This is what I teach my therapy clients. This is the things I'm talking about all the time on this podcast, or when I do disordered with Josh Fletcher, we're talking about this stuff all the time. That is the avoidance. So, what you really have to think about is, okay, what is it that triggers me? The trigger is irrelevant. It's symptoms, or it's sensations, or it's particular thoughts, or emotions, or words that I hear, or certain news stories, or topics that may come up in conversation, or maybe the sensations or thoughts that you fear are triggered by particular situations or contexts. This is common in agoraphobia. If I leave the house, I start to feel anxious and panicky. If I go out of my safe zone, my body starts to go into fight or flight mode. So, therefore, I got to go back home so that I can feel safer. You are not avoiding the highway. You are not avoiding driving. You are not avoiding leaving your house. You're not avoiding crowded places, you're not avoiding your grandma's birthday party or your cousin's wedding, you are avoiding discomfort. So, keep in mind, if you can think about, well, what triggers me into a state of discomfort or fear or we'll call it distress in general, what do I do to try to get away from that distress? That is my avoidance behavior, and that's the thing I have to work on not doing. So, I understand that this doesn't make a lot of common sense, and especially for people with OCD and GAD presentations, it will often feel like, but if I don't answer the thought, that means I'm ignoring the problem because the thought seems like a problem. No, that's not true. The thought just happens to be a trigger into discomfort. And if you've unfortunately dealt with this stuff for any length of time, you will probably see that the thoughts and the themes have changed. What you were afraid of 6 months ago is not what you're afraid of now. The theme that your OCD has latched onto now is different than maybe it was a year or two ago, or it's changing, or morphing, or growing, or and or just kind of, you know, changing shape. If you are a GAD sufferer, you know that GAD will latch onto just about anything in life that could be potentially difficult or dangerous. Oh my god, what about my family? What about my career? Am I being the best parent I can be? Am I being the best person I can be? Do I know I'm a good person, which is an OCD overlap? What What am I going to do to provide for my family? What if I'm missing something? What if I'm not the fastest person in the room? What if I'm not the problem solver or the caretaker? What if I'm not the loving person in the room that worries about everybody and that proves that who I really am, who I want to be? Those all feel like actual problems that you have to address. Well, if I feel like not worrying about my kids makes me a bad parent, then if I just let that worry be there and just go on to something else that isn't worrying about my kids actively, aren't I ignoring that? Like I'm supposed to be a good parent, so I'm ignoring the problem, avoiding the problem. No, you're just trying to get away from your discomfort. And again, it's it's difficult because it doesn't make a lot of common sense. It it seems like the content of your fear is the problem that you should not be avoiding, but you actually are trying to avoid perpetuating the process whereby thoughts, sensations, that's the content, triggers discomfort, and then you try to alleviate your discomfort. So, if you think in terms more of process instead of content, triggers are relevant, only the anxiety, the fear, the discomfort, the distress we care about, and you start to get a better handle a better handle on what it is you're avoiding and not avoiding. So, it is perfectly okay to learn to have a really scary thought or feel a bodily sensation that you hate and are terrified rise up inside of you and do nothing about that. That's hard to do, but it is perfectly okay to do that. You are not avoiding a problem or avoiding something if you do that. That's actually what you want to do. Because in the end, what all you're really avoiding, and we're trying to get rid of that avoidance, is you're just trying to avoid your own discomfort, which makes sense. I mean, if you were trying to avoid financial ruin, that would make sense. If you're trying to avoid being really uncomfortable, that also makes sense. And in certain instances in life, we can try to, you know, act on our discomfort or avoid it if it's not necessary, but in anxiety disorders, we can't avoid it, and the attempt to continually control our own discomfort, avoid it, get away from it, just goes off the rails and never ends. That's the difference between anxiety and anxiety disorders. Externally focused anxiety versus internally focused anxiety. Externally generated triggers versus internally generated triggers. That's the difference. So, if this is something you have been confused about, I had somebody who commented on one of my Instagram posts, and by the way, if you're not following on me on Instagram, you could do that. I'm the.anxious.truth, who was very confused when I talked about like, no, you don't you don't have to do all these things to try to prove your thoughts wrong." And they said, "Well, isn't that I'm confused. Isn't that avoiding the problem?" No, no, the problem is everything you do to feel better when you have a scary thought. So, as always, this doesn't make common sense. It's almost upside down. It's backwards. It's one of the reasons why so many people who are in the business of therapy and mental health don't really understand how to work with anxiety disorders. And we're going to talk more about that as we go down the road here, but um it doesn't make common sense. You have to really look and say, "Hang on a second. I have to look below the surface here." Which doesn't mean digging for like hidden things or into your subconscious or anything like that. But, the the surface is the the content, the triggers, the sensations, the places, the actual thoughts, the the specific fears. That's the surface. I got to look underneath that and say, "Wait a minute, what's actually going on here?" Oh, that thought makes me really uncomfortable and I'm trying to argue with the thought to eliminate the discomfort. Oh, that sensation really scares me and it makes me feel like I'm in danger. So, I'm trying to do anything I can to eliminate that sensation or get away from it so I don't feel like I'm in danger. See how that works? Everything you do in an anxiety disorder is always designed to try to alleviate your anxiety, your fear, discomfort, your distress. That's the avoidance. So, um told you 15 or 20 minutes. That's kind of it. I don't really have anything else to say about that except to if it's confusing to you, maybe take a little bit of time and think about that on a process versus content versus process basis. What is the content of my anxiety right now? Oh, it's thoughts about accidentally being unfaithful to my partner or or accidentally harming children or not actually knowing what my sexual orientation is or I don't know, losing my sanity even though there's no proof that I'm losing my sanity or maybe it's somatically based or maybe it's a health focus and every time I feel something new in my body it it turns into like I clearly have a terminal illness that will kill me and take me away from my family. Whatever it is, that's the content. What's the process underneath that? Spend some time to think about that. Oh, yeah. I have health anxiety which means I go pounding on a keyboard with chat GPT or Gemini or Claude or whatever you like to use which by the way you should stop doing that to try to prove to myself that what I'm experiencing is okay and I don't need a doctor and it's actually not some sort of crazy unheard of form of cancer that's untreatable. That's the stuff we want to look at. So you want to take a little bit of time, think about the process that keeps repeating, especially like I said if you have had symptoms that morphed. I used to be afraid of my heart, now I'm afraid of DPDR, I used to be afraid of air hunger, now I'm afraid of nausea, I used to have relationship OCD, now I'm in more of a harm theme. I my health anxiety was focused on cancer, now it's focused on something completely different or my health anxiety is morphed so now I'm concerned with my partner or my family and not myself. If you can see how your targets have morphed over time, just look at what the common process is, which is I get scared and uncomfortable and I try to fix that. So the avoidance is trying to fix the scared and uncomfortable and that's entirely internal. So hopefully that helps explain it. If you're confused about what is avoidance and what is not, maybe this gives you a clearer picture because it is true that avoidance tends to help create an anxiety disorder and perpetuate it and the same holds true with OCD. Every time your OCD triggers discomfort, if you perform a compulsion or a ritual to make that discomfort go away, even if it's only temporary, you are perpetuating the the process. We're we're trying to avoid the discomfort and that's what makes things worse. So that's why you hear people like me talk about avoidance, avoidance, avoidance is bad, avoidance is bad, we have to eliminate the avoidance. We're just trying to eliminate trying to avoid how you feel. It's okay to feel bad. Nobody wants to. It's okay to feel anxious. Nobody wants to. It's okay to feel afraid in the absence of actual danger. Nobody wants to. But when we eliminate that avoidance, we actually call it experiential avoidance, avoiding our own internal experience, we learn through those experiences that fear and danger are not always the same. Thoughts feel real, but they are not. Like threats often appear to be right in front of us when no such threat exists. That's how we teach our brains those valuable lessons by eliminating the avoidance of discomfort and allowing ourselves to work through it. So, that's the crux of avoidance. There you go, 20 minutes. Not too shabby, almost right on the dot. Hopefully this helped. I appreciate it if you hung out all this time. If you're watching on YouTube, it has sort of come to my attention that the vast majority of people who watch these videos are not subscribed to the channel. Now, YouTube is not a big fan of mental health content. They tend to bury it. So, if you like what's happening on my YouTube channel, you like this video, hit the like button on the video, maybe consider subscribing to the channel. It's nothing for you, it means a lot for me because it tells YouTube that you actually care about the content that I make and maybe they're mess less likely to bury my hours of effort in algorithm like pits in the dungeons of the algorithms, right? And I will close, as always, with a little reminder that no matter how small you shift in from the old direction, avoidance, control, escape, saving, to a new direction, which is I'm going to try to face what I fear and learn that I am in fact capable of handling that without the fearing an emergency. No matter how small that shift is that you make today, it counts. They actually all add up over time. They pile on top of each other and sometime in the future, if you're able to do these little shifts consistently every day, while being patient and kind to yourself, suddenly you look back and your starts life starts to look a little different. I know it's hard, simple plan, hard to execute. If I didn't think you could you would could do it, I wouldn't be talking to this dumb microphone every 2 weeks, but I think you can. And hopefully you will begin to experiment with that. I will try to help as best I can within the limits of this particular model, one of me, many of you. Uh thanks for hanging in there today if you made it this far. I'll be back again in two weeks with another topic. Not sure what that's going to be. And of course every Friday the Disordered podcast with Josh Fletcher comes out. You can find that at disordered.fm. And if you want to talk about what you heard today on the Anxious Truth or interact with me or Josh or community people who share your common experience. This is not gatekeeping a cure. This is not a cult. We are not promising that you're going to instantly get better or find freedom, air quotes, if you join this thing. You can check out the Disordered community space. That's at disordered.fm/community. Thanks for hanging out. See you in two weeks. We're out.